Oxycodone / naloxone combination

A sustained-release (SR) preparation of oxycodone with naloxone has recently been developed. The aim was to provide around-the-clock analgesia for patients with severe pain with less opioid-induced constipation.
Studies show the new preparation provides equivalent analgesia to the previously available oxycodone SR preparation, with some lessening of constipation. Other side effects are similar. The naloxone that is absorbed is largely metabolized in the liver, although patients taking other opioid drugs may experience some withdrawal symptoms when starting the new preparation. The manufacturer advises that the new preparation is contraindicated in patients with moderate or severe hepatic dysfunction.
Detractors point to the increased cost and the fact that it has not been compared with rigorous standard treatment for constipation.
Although it has probably not been formally tested, the new preparation should remove the potential for abuse. It is reported that the oxycodone SR preparation, after crushing, was used as an IV injection by dependent individuals. With the new preparation, this would presumably result in a substantial dose of IV naloxone.

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